How would you apprach a SLE patient who is planning pregnancy on hydroxychloroquine with a high titer dsDNA who cannot tolerate azathioprine and whose only symptom is arthralgia?

In an SLE patient planning pregnancy whose only clinical manifestation is arthralgia, hydroxychloroquine monotherapy is appropriate. During the pregnant and non-pregnant state, additional immunosuppression is not indicated for a high titer dsDNA; rather, monitoring for organ manifestations is approp...